Delivery of nebulized medicines

ABSTRACT

Devices are disclosed that include a positionable elongated member configured to support and delivery tube and maintain a distal end of the tube in a desired position, and to allow the position of the distal end of the tube to be adjusted by a user, and an attachment device configured to allow a proximal end of the elongated member to be secured in a fixed position. These devices may be used, for example, in the delivery of vaporized medicine to a patient, e.g., a child or infant on a bed.

CROSS-REFERENCE TO RELATED APPLICATION

This patent application is a continuation of PCT/US2013/039324, filedMay 2, 2013, which claims priority to U.S. Provisional Application No.61/647,084, which was filed on May 15, 2012, and U.S. Ser. No.13/663,861, filed Oct. 30, 2012. The entirety of each of theseapplications is incorporated herein by reference.

BACKGROUND

Many respiratory diseases, including asthma, are treated with the use ofa device called a nebulizer. These “nebulizers” take liquid or solidmedication (such as respiratory steroids) and, through compressed air orother technologies, nebulize the medication into a fine mist that isthen blown through a tube into a mask. Generally, the followingconditions must be met during delivery of the nebulized medicine: a) themask must be placed on a cooperative patient's mouth and nose, b) thepatient must sit in an upright position, c) the mask must form a tightseal on the patient's face, and d) the medicine must be administered fora fairly extended period, e.g., 10 minutes, with the patient in thisstate. During this process (a)-(d) are often not possible, and thepatient may be uncooperative during the treatment resulting in anincomplete or ineffective treatment. If treatments are not giveneffectively on a regular basis the result is often deterioration of therespiratory condition, often resulting in an attack that sends thepatient to the Hospital or Emergency Room.

Research has identified that treatments given at night while the subjectis sleeping are most effective due to the deep regular breathingconditions achieved during sleep. Medication delivered to a sleepingsubject penetrates deeper into the lungs, allowing more effectivetreatment and prevention of respiratory attacks. However, whendelivering treatments to a sleeping patient, parents or caregivers areoften forced to manipulate nebulizer devices or use them ineffectively.

In hospital settings where multiple infants, or patients haverespiratory conditions that require nebulized medical treatments, nursesand care givers are required to administer treatments on an individualbasis. Due to current limitations in respirator medical devices, nursesand caregivers generally must physically hold a mask on or near apatient's face and carefully watch that the medicine cup is held in anupright orientation.

SUMMARY

Generally, this invention relates to devices and methods for delivery ofa nebulized medicine to a patient. The devices disclosed herein may beconfigured for use in environments such as patients' homes, hospitals,doctors' offices, and nursing homes.

In some embodiments, the devices are configured so that the patient mayremain in his or her current location, positioning, and state (e.g.,sitting in a chair or lying down, either asleep or awake) and the devicecan be transported and positioned in such a manner as not to disrupt orseriously change the patient's current state, minimizing the likelihoodof sending the patient into an uncooperative state where treatments areless effective. In some cases, the devices can be used hands-free bysuspending a portion of the device in a position to effectively delivermedication in close proximity to the nose and mouth of the patientwithout touching the patient. In preferred implementations, unlike maskdelivery or intubation, delivery using the devices disclosed herein issubstantially “contact-free,” without a mask or other portion of thedevice contacting the patient's nose or mouth.

In some implementations, the devices are used for delivery of nebulizedmedicines to infants in a hands-free manner, allowing nurses toadminister treatments to multiple infants at one time.

In one aspect, the invention features a device that includes apositionable elongated member configured to support a delivery tube andmaintain a distal end of the tube in a desired position, and to allowthe position of the distal end of the tube to be adjusted by a user(e.g., a patient, caregiver, or clinician); and an attachment deviceconfigured to allow a proximal end of the elongated member to besupported in a fixed position.

Some implementations may include one or more of the following features.

The positionable elongated member may include an articulated armassembly, which may, for example, comprise two or more, in some casesthree or more, arm segments that are configured to pivot and/or swivelrelative to each other. Alternatively, or in addition, the positionableelongated member may include a positionable tubular member, e.g., acontinuously positionable metal tube such as gooseneck tubing or thelike.

The positionable elongated member may include or contain a light or lampconfigured to allow the user to illuminate a treatment area, e.g., thepatient's face. Moreover, a nozzle may be disposed at a distal end ofthe positionable elongated member. The nozzle is configured to deliver aspray of liquid mist, or nebulized medicament from the delivery tube,and may in some cases be configured to allow a user to adjust adistribution pattern of the vaporized medicament. In some cases, thelight or lamp is disposed in or adjacent to the nozzle. The nozzle maybe positionably attached to the distal end of the positionable elongatedmember, e.g., by a ball joint that defines a bore.

In some cases, the device further includes a medicine cup, or nebulizermounted on the positionable elongated member in fluid communication withthe delivery tube during use of the apparatus. The medicine cup may bemounted so that the axis of the medicine cup will remain substantiallyvertical during use of the apparatus.

In some cases, the device further includes the delivery tube, which maybe disposable. When the device is used in a hospital or other clinicalsetting the delivery tube is generally disposable after a single use,whereas in a home setting the tube may be used for multiple uses priorto replacement.

The attachment device may comprise a flat base, e.g., configured to slipunder a mattress or pillow, and/or to rest flat on a floor or table. Inother embodiments, the attachment device may comprise a wall mount orclamp, e.g., a clamp configured to mount on a headboard of a bed. Insome cases, the attachment device may be interchangeable, e.g., betweena flat base, a wall mount, and a clamp. In some cases, the proximal endis coupled to the attachment device so as to allow rotational orpivoting motion of the proximal end.

The invention also features methods of delivering nebulized medicines.In one aspect, the invention features a method that includes deliveringnebulized medicine to a patient, without the use of a mask, bypositioning the distal end of a delivery tube adjacent the face of thepatient using a positionable elongated member configured to support thedelivery tube in a desired position relative to the patient.

Some implementations include one or more of the following features.

The method may further include, prior to the delivering step, adding asupply of the medicine, in liquid form, to a vaporizer configured todeliver the vaporized medicine to the elongated member. For example, thesupply of medicine may be added to a medicine cup mounted on theelongated member or on the base of the device described above.

In some cases, the patient may be lying down, either sleeping or awake.The patient may be an infant, a small child, or an adult. The medicinemay, for example, be an asthma medicine.

A nozzle may be mounted at the distal end of the delivery tube. In somecases the nozzle is adjustable, and the method may further includeadjusting a distribution pattern of the nebulized medicine using theadjustable nozzle.

The method may further include directing a light that is associated withthe positionable elongated member to illuminate a desired target area onthe face of the patient during treatment. This light may also be used toindicate position and/or distance relative to the patient's nose andmouth. For example, in some implementations as the nozzle moves out ofposition the light will fade or move off target. The light may thus beused to aid in the proper positioning of the distal end of the device.In some implementations, the light is configured so that light intensitywill increase/decrease proportionately with changes in the mistdelivery/density with respect to the patient's nose and mouth.

The method may further include, during delivery of the spray to thepatient, delivering a spray of nebulized medicine to a second patient,without the use of a mask, by positioning the distal end of a seconddelivery tube adjacent the face of the second patient using apositionable elongated member configured to support the delivery tube ina desired position relative to the second patient. In this manner,several patients, e.g., several children in the same family in a homesetting, or several infants in the same ward in a hospital setting, maybe given treatment simultaneously.

The description may use perspective-based descriptions such as up/down,back/front, and top/bottom. Such descriptions are merely used tofacilitate the discussion and are not intended to restrict theapplication of the embodiments of the present invention.

As used herein, the term “compressor” refers to any device thatcompresses air, for example an electrically powered unit, which may bepowdered, e.g., by direct wall alternating current (AC volts), or directcurrent (DC volts) by means of either battery voltage or an AC volts toDC volts converter. The compressor is understood to take in atmosphericair and compress it to some output magnitude greater than atmosphericpressure.

As used herein, the term “vaporizer” is used to describe an apparatusthat transforms drugs into small fine particles that are necessarilylighter than their bulk solid or liquid form and thus can be conveyed ina partially suspended state by means of an air current. The device isnot limited to a particular method, manufacturer, or technology. Avaporizer described in this invention is not necessarily dependent onthe compressor and can operate independent of a compressor, eliminatingthe compressor from the system.

As used herein, the term “nebulizer” refers to the entire system ofcreating small partially suspended medication conveyed by air current.This could contain, but is not limited to, a compressor and vaporizercup, or just a vaporizer, as well as any other technology that createsand conveys treatments through air to be inhaled by patients.

As used herein, the terms “nebulized medication,” “nebulized drugs”,“vaporized medicine,” and variants of these terms, refer to the productoutput by the nebulizer where particles of medication or drugs arepartially or fully suspended in an air medium.

As used herein, the term “tubing” is used to describe a hollow flexibleapparatus used to convey either air or air and vaporized medicationbetween locations within the device, or between different devices withinthe system.

As used herein, the term “nozzle” refers to the final exit point ofnebulized medication, at which the nebulized medicine is conveyed to thepatient to be inhaled.

As used herein, the terms “articulating,” “articulation” and theirderivatives, describe two parts that are coupled in a manner that allowsrelative rotational, radial, or translational motion of two or morecomponents of the device.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a device according to one embodiment, inwhich the device includes an articulated arm.

FIG. 1A is a cross-sectional view of an arm of the device shown in FIG.1 with a delivery tube in place.

FIG. 2 is a perspective view of a device according to an alternateembodiment, in which the device includes a continuously flexible arm.

FIG. 3 is a side plan view of the device shown in FIG. 1, showing thedevice positioned for use with its base fixed under a mattress.

FIG. 4 is a cross-sectional view of a ball joint that may be used toconnect the nozzle to the articulated arm in the device shown in FIG. 1.

FIG. 5 is a diagrammatic view illustrating laminar flow from the nozzleof the device.

FIG. 6 is a side view of a nozzle according to one embodiment, and FIG.6A is a cross-sectional view of the nozzle taken along line A-A in FIG.6.

FIG. 7 is a perspective view of the nozzle shown in FIGS. 6 and 6A.

FIG. 8 is a perspective view showing the nozzle of FIGS. 6-7 assembledwith a receiver containing lighting electronics.

FIG. 9 is an exploded view of the components shown in FIG. 8.

In the following detailed description, reference is made to theaccompanying drawings in which are shown by way of illustrationembodiments in which the invention may be practiced. It is to beunderstood that other embodiments may be utilized and structural orlogical changes may be made without departing from the scope of thepresent invention. Therefore, the following detailed description is notto be taken in a limiting sense, and the scope of embodiments inaccordance with the present invention is defined by the appended claimsand their equivalents.

DETAILED DESCRIPTION

Referring to FIG. 1, in one embodiment a nebulized medicine deliverydevice 10 includes a positionable elongated member 12 supported by abase 14. In the embodiment shown in FIG. 1, the positionable elongatedmember 12 includes a first arm 16 which is coupled to the base 14 at itsproximal end 17, and positionably coupled to a second arm 18 by anarticulating hinge 20 at its distal end 22. As indicated by arrow A, theproximal end 17 of the first arm is preferably mounted on the base 14 sothat it can rotate, and in some cases pivot, with respect to the base toenhance the overall positionability of the device. It is generallypreferred that movement be limited to rotation, as indicated by arrow A,so that the first arm 16 remains generally vertical. While rotation ispreferred, if desired the first arm can be fixedly mounted to the base.The articulating hinge 20 allows the first arm 16 and second arm 18 topivot about the axis of the hinge in the manner indicated by arrow B,

The device 10 also includes a compressor 40 which delivers compressedgas (e.g., air) to a medicine cup 42 which, when the device is in use,contains a supply of medicine. The medicine cup 42 is connected to thefirst arm 16 so as to hold the medicine cup in a stable, substantiallyvertical position during delivery of the medicine to enhance theeffectiveness of the vaporizer. The compressor is connected to a powersupply (not shown). Medicine is nebulized in the medicine cup and thendelivered to the patient via a delivery tube 44. As shown in detail inFIG. 1A, the delivery tube 44 is disposed in a channel 46 in the firstarm 16. The second arm 18 includes a similar channel (not shown). Thesechannels allow the tube to be held securely but removable within thepositionable elongated member 12. Because the delivery tube is removablefrom the channel it can be easily replaced.

A nozzle 24 is mounted at the distal end 26 of the second arm, fordelivery of the vaporized medicine to an area adjacent the patient'sface. For example, delivery can be directed toward the patient's noseand mouth, so that the patient will receive the medicine regardless ofwhether she is breathing through her mouth or nose. Mounting of thenozzle may be by a pivotable connection, e.g., a ball joint 28, asshown, to provide fluid communication between the nozzle 24 and thedelivery tube 44 while allowing the position of the nozzle to be finelyadjusted as indicated by arrows C. An example of a suitable structurefor the ball joint is shown in detail in FIG. 4.

As shown in FIG. 4, the ball joint includes a ball 30 that defines abore 32 and a socket 34 that receives the ball 30 and defines a bore 36that is in fluid communication with bore 32 in all rotational positionsof the ball. Together, the bores 32 and 36 communicate with the boredefined by the delivery tube 44, allowing delivery of the vaporizedmedication through the ball joint to the nozzle. The ball may beintegral with the nozzle, as shown, or may be separate from the nozzleand attached to the nozzle, e.g., by a snap fit or other engagement. Theball joint allows the position of the nozzle to be continuouslyadjustable in both an angular and rotational axis to create positioningin a full hemispherical attitude. The nozzle and ball joint may bereplaceable, along with the delivery tube, or may be sterilizable.

While the device shown in FIG. 1 has only two arms, a third arm, ormultiple articulated arms, could be interposed between the second armand the nozzle if desired, to provide further articulation. In thiscase, the axes of rotation of the various hinges between the arms may beoriented differently. For example, if a third arm (not shown) wereinterposed between the second arm 18 and the nozzle 24, the hingeconnecting the second and third arms could have an axis of rotationperpendicular to that of the hinge 20 that connects the first arm 16 tothe second arm 18 in FIG. 1. If desired any of the joints could bereplaced by ball joints to provide 2 axes of freedom and accommodate abroader range of motion.

If desired, the nozzle 24 may be omitted and the vaporized medicinesimply delivered from the end of the delivery tube, or a different typeof nozzle may be used, e.g., a spray head (not shown) which may beadjustable, e.g., in the manner of an adjustable garden hose sprayer.

FIG. 1 includes arrows depicting degrees of freedom and axes of motionthat may be favorable in this particular embodiment; however additional,fewer, or different motions may be incorporated in other embodiments.

FIG. 2 depicts an alternative device 110, in which the articulating armsshown in FIG. 1 are replaced by one continuous flexible member 112. Thisflexible member needs to be sufficiently rigid so as to maintain thedelivery tube in a desired position, without support by the user, duringuse of the device, while being sufficiently flexible so as to allow theuser to easily position and reposition the distal end of the flexiblemember without having to exert undue effort. One suitable type offlexible member is the flexible, multisegmented tubing referred to as“gooseneck tubing.” Other types of positionable metal or plastic tubingmay also be used.

As discussed above with regard to FIG. 1, the flexible member 112 ismounted at one end on a base 14. In this case, due to the continuousflexibility of member 112, mounting is generally fixed, though rotatablemounting (as shown in FIG. 1) may be used if desired. The flexiblemember may be hollow, so that the delivery tube 44 may be routed throughthe flexible member 112, as shown, or may be solid, in which case thedelivery tube is secured, e.g., clipped, to the flexible member 112 atvarious points along its length (not shown.) A nozzle 24 and vaporizer42 are mounted on the flexible member 112 as in the embodiment shown inFIG. 1. Due to the continuous flexibility of member 112 the ball jointconnection between the member 112 and the nozzle 24 may in some cases beomitted. However, a ball joint (not shown) may be provided if fineadjustability of the nozzle relative to the patient's face is desired.

During use, the nozzle 24 may be adjusted to any position within thereach of the flexible member 112. It is generally preferred that theflexible member 112 not be extended so far horizontally that itsproximal portion, where the medicine cup is mounted, ceases to begenerally vertical or stable. To prevent this overextension, in somecases a proximal portion of the member 112, between the base andmedicine cup, may be rigid or less flexible than the remainder of themember 112.

As shown in FIG. 3, in some embodiments the base 14 of device 10 can beconfigured to be placed under a mattress or pillow 50 and the second arm18 can suspend over a bed 52, allowing the nozzle to be positioned inclose proximity to a sleeping patient's nose and mouth. Alternatively,the base 14 may be configured to be attached directly to a hospital bedframe to accommodate patients within the clinical or hospital system. Inother embodiments, the device may be clamped to the bed, e.g., to aheadboard, bedframe, or to another object such as a table or verticalstand, or may have a base that will sit flat on the floor. While thearrangement shown in FIG. 3 utilizes the articulated device shown inFIG. 1, the continuously flexible device shown in FIG. 2 may be used ina similar manner.

Preferably, the delivery device is configured to provide laminar flow ofthe vaporized medicine for a sufficient distance from the nozzle toallow the nozzle to be positioned a comfortable distance from thepatient's face, i.e., to prevent the vaporized medicine from dispersingbefore it reaches the patient. It is also preferred that the device beconfigured so that beyond that distance (where the patient's face willbe positioned) the laminar flow broadens out to a more dispersed streamor cloud. For example, as shown in FIG. 5 the nozzle may provide about 4to 8 inches of laminar flow, followed by about 2 to 4 inches of abroader, dispersed stream. In some implementations the laminar flow isvisible, allowing easy visualization by a caregiver, clinician, orpatient during delivery to the patient.

Several features of the device are believed to contribute to the laminarcharacteristics of the flow from the nozzle.

First, the delivery path of the vaporized medicine from the medicine cupto the nozzle is at least initially, in the vicinity of the medicinecup, straight or relatively straight. The lack of any abrupt changes ofdirection of flow is believed to contribute to the establishment oflaminar flow.

Second, in preferred implementations the nozzle geometry is configuredto enhance laminar flow, while limiting the distance of laminar flow tothe expected distance between the nozzle and patient. An example ofsuitable nozzle geometry is shown in FIGS. 6-7. Referring to FIG. 6A,nozzle 100 includes a barrel section 102, having a generally cylindricalcross-section to enhance laminar flow, and an exit section 104, having agenerally frustroconical or semi-spherical cross-section. The geometryof the exit section is configured to cause the stream to disperse at arelatively short distance (e.g., 2 to 8 inches) from the rim of thenozzle.

Nozzle 100 also includes bores 106 that allow light to be directedthrough the nozzle towards the patient, e.g., to facilitate delivery ofmedicine to a sleeping patient in a darkened room. Referring to FIGS. 8and 9, light is delivered to the bores via a nozzle mount 108, whichhouses a lighting system 110, shown in FIG. 9 and described below. Thenozzle 100 includes a clearance area 111 (FIG. 6A) for receiving adistal portion of the lighting system that extend from the nozzle mount108.

The nozzle mount 108 is preferably fixedly attached to the distal end ofthe positionable elongated member 12 (not shown in FIGS. 8-9), e.g., byadhesive, ultrasonic welding or other suitable attachment methods. Insome cases, the nozzle mount may be removable, to allow easy replacementof the lighting system as a module.

The nozzle 100 is removably attachable to the nozzle mount, to allow thenozzle to be easily disposable and replaceable by the user. In theembodiment shown in FIGS. 6-9, the nozzle is removable by depressingquick attach member 112, which has a tab 114 configured to fit into acorresponding opening 116 on the nozzle mount 108. Other methods ofquick-release attachment may be used. Guide pins 115 are provided on thenozzle mount 108 to assist the user in properly aligning the nozzle 100on the nozzle mount 108.

The nozzle 100 may be provided as a separate part, which can beconnected to the delivery tube 44 (FIG. 1A) by the user, or may bepre-attached to the distal end of the delivery tube 44. In the lattercase, the nozzle and delivery tube would be sold to the user as a unitfor ease of replacement. In either case, the delivery tube 44 is mountedon receiving portion 120 (FIG. 6A) of the nozzle 100.

Referring now to FIG. 9, the lighting system 110 includes an actuatorbutton 122, mounted in an opening 124 in the nozzle mount 108, which isdepressed by the user to actuate an underlying switch 126 to turn thelighting on and off. This switch 126 is in electrical communication witha printed circuit board 128, on which are mounted two lights 130, e.g.,high intensity LEDs. The lights 130 are positioned to align with bores106 such that light from the lights is projected through the bores 106onto the patient.

In use, the base 14 may be positioned on the floor or in any desiredlocation, and the positionable elongated member 12 used to position thenozzle in various locations in space so that the nozzle is generallyadjacent to the patient's face. The orientation of the nozzle can thenbe finely adjusted to the patient's face through the motion of therotating ball joint, if a ball joint is provided. Adjustment of thepositioning of the device can be facilitated by visualizing the laminarflow of the vaporized stream from the device, and further enhanced byturning on the lighting. Once the position of the device has beenadjusted in this manner, the device can be used hands-free, with theuser needing only to monitor the patient and readjust the position ofthe nozzle if the patient moves out of position relative to the nozzle.

OTHER EMBODIMENTS

A number of embodiments have been described. Nevertheless, it will beunderstood that various modifications may be made without departing fromthe spirit and scope of the disclosure.

For example, while asthma treatments have been discussed above, thedevices and methods disclosed herein may be used for the delivery of anytype of vaporized medicine, and in any type of treatment involving suchdelivery. Other treatments include treatment of cystic fibrosis, croup,pneumonia, and other respiratory conditions. The devices and methods mayalso be used to deliver gases to patients, for example for substantiallycontact-free, hands-free oxygen delivery to a patient that cannottolerate a mask or nasal cannula due to facial trauma or other issues.

Moreover, while various applications have been discussed above, thedevices and methods may be used in many other applications wherenon-contact and/or hands-free delivery would be advantageous. Forexample, the devices may be used by paramedics or other EMS personnel insituations where the caregiver should remain seated, e.g., in a movingambulance or other transport.

Also, in some devices the compressor and/or vaporizer may be integrallyincorporated into the device, which may eliminate some tubes andconnections.

Moreover, in various embodiments, not shown or described, variousaspects may be modified to accommodate extended positioning of thedevice to reach more and additional degrees of freedom to adapt todifferent environments. The shape, size and configuration shown in thedrawings and discussed above are meant only as an example and are notintended to be limiting.

Accordingly, other embodiments are within the scope of the followingclaims.

What is claimed is:
 1. An apparatus comprising: a positionable elongatedmember configured to support a delivery tube and maintain a distal endof the tube in a desired position, and to allow the position of thedistal end of the tube to be adjusted by a user; and an attachmentdevice configured to allow a proximal end of the elongated member to besupported in a fixed position.
 2. The apparatus of claim 1 wherein thepositionable elongated member comprises an articulated arm assembly. 3.The apparatus of claim 1 wherein the positionable elongated membercontains a light or lamp configured to allow the user to illuminate atreatment area.
 4. The apparatus of claim 3 wherein the light or lamp isconfigured to be used as a targeting system to locate the distal end ofthe tube with respect to the patient's nose and mouth.
 5. The apparatusof claim 2 wherein the articulated arm assembly comprises two or morepivotably connected arm segments.
 6. The apparatus of claim 1 whereinthe positionable elongated member comprises a positionable tubularmember.
 7. The apparatus of claim 6 wherein the tubular member comprisesgooseneck tubing, or continuously adjustable/flexible hollow tubing 8.The apparatus of claim 1 further comprising a nozzle disposed at adistal end of the positionable elongated member.
 9. The apparatus ofclaim 8 wherein the nozzle is configured to deliver vaporized medicamentfrom the delivery tube.
 10. The apparatus of claim 9 wherein the nozzleis configured to allow a user to adjust a distribution pattern of thevaporized medicament.
 11. The apparatus of claim 10 wherein the nozzlemay contain a light or lamp configured to allow the user to illuminate atreatment area and/or to target specific areas of a patients face withrespect to the nozzle outflow.
 12. The apparatus of claim 11 wherein thelight or lamp is configured to allow light intensity toincrease/decrease proportionately with mist delivery/density withrespect to the patient's nose and mouth.
 13. The apparatus of claim 8wherein the nozzle is attached to the distal end of the positionableelongated member by a ball joint that defines a bore.
 14. The apparatusof claim 1 further comprising a vaporizer mounted on the positionableelongated member in fluid communication with the delivery tube duringuse of the apparatus.
 15. The apparatus of claim 14 wherein thevaporizer is mounted so that a long axis of the vaporizer will remainsubstantially vertical during use of the apparatus.
 16. The apparatus ofclaim 1 further comprising the delivery tube.
 17. The apparatus of claim16 wherein the delivery tube is disposable.
 18. The apparatus of claim 2wherein the positionable member includes at least three arm segments.19. The apparatus of claim 1 wherein the attachment device comprises abase.
 20. The apparatus of claim 19 wherein the base is configured toslip under a mattress.
 21. The apparatus of claim 19 wherein the base isconfigured to rest flat on a floor or table.
 22. The apparatus of claim1 wherein the attachment device comprises a wall mount or clamp.
 23. Theapparatus of claim 1 wherein the proximal end is coupled to theattachment device so as to allow rotational or pivoting motion of theproximal end.
 24. A method comprising: delivering a vaporized medicineto a patient, without contact between the delivery device and thepatient or the use of a mask, by positioning the distal end of adelivery tube adjacent the face of the patient using a positionableelongated member configured to support the delivery tube in a desiredposition relative to the patient.
 25. The method of claim 24 furthercomprising, prior to delivering, adding a supply of the medicine, inliquid form, to a vaporizer configured to deliver the vaporized medicineto the elongated member.
 26. The method of claim 24 wherein the patientis lying down.
 27. The method of claim 24 wherein the patient is aninfant or child.
 28. The method of claim 22 wherein the medicinecomprises an asthma medicine.
 29. The method of claim 24 wherein anadjustable nozzle is mounted at the distal end of the delivery tube andthe method further comprises adjusting a distribution pattern of thevaporized medicine using the adjustable nozzle.
 30. The method of claim24 further comprising directing a light that is associated with thepositionable elongated member to illuminate a target area on the face ofthe patient during treatment.
 31. The method of claim 30 furthercomprising switching the light off during or after treatment.
 32. Themethod of claim 24 further comprising, during delivery of the vaporizedmedicine to the patient, delivering a vaporized medicine to a secondpatient, without the use of a mask, by positioning the distal end of asecond delivery tube adjacent the face of the second patient using apositionable elongated member configured to support the delivery tube ina desired position relative to the second patient.